Toshihiro Shirai1, Keita Hirai2, Yasuhiro Gon3, Shuichiro Maruoka3, Kenji Mizumura3, Mari Hikichi3, Cecile Holweg4, Kunihiko Itoh2, Hiromasa Inoue5, Shu Hashimoto3. 1. Department of Respiratory Medicine, Shizuoka General Hospital, Shizuoka, Japan. Electronic address: toshihiro-shirai@i.shizuoka-pho.jp. 2. Department of Clinical Pharmacology and Genetics, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan; Laboratory of Clinical Pharmacogenomics, Shizuoka General Hospital, Shizuoka, Japan. 3. Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan. 4. Genentech Inc., South San Francisco, Calif. 5. Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
Abstract
BACKGROUND: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) has been proposed as a different diagnosis from asthma and COPD. However, little is known about the role of serum biomarkers in ACO. OBJECTIVE: To evaluate serum periostin, a type 2 biomarker, and serum chitinase-3-like protein 1 (YKL-40), a useful biomarker for COPD, in Japanese patients with asthma, ACO, or COPD, and investigate the role of these biomarkers in identifying ACO. METHODS: Subjects included Japanese patients with asthma (n = 177), ACO (n = 115), or COPD (n = 61). Serum periostin, YKL-40, and total IgE, blood eosinophils, and fractional exhaled nitric oxide were measured and compared among the patients. RESULTS: Serum periostin was high in both asthma and ACO, but not in COPD, whereas serum YKL-40 was high in both COPD and ACO, but not in asthma. Serum periostin levels correlated weakly with eosinophil counts in asthma, ACO, and COPD. Multivariate linear regression analysis revealed that older age, lower body mass index, higher eosinophil counts, higher total IgE, and the absence of the diagnosis of COPD were significantly associated with higher periostin levels. Based on cutoff values derived by receiver operating characteristic analysis (periostin: 55.1 ng/mL; YKL-40: 61.3 ng/mL), patients were classified into high or low groups. The proportion of patients with both high serum periostin and YKL-40 levels was significantly higher in ACO than in asthma or COPD. CONCLUSIONS: Serum periostin levels were comparable between asthma and ACO, whereas YKL-40 was comparable between ACO and COPD. Combined assessment of serum periostin and YKL-40 may identify ACO.
BACKGROUND:Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) has been proposed as a different diagnosis from asthma and COPD. However, little is known about the role of serum biomarkers in ACO. OBJECTIVE: To evaluate serum periostin, a type 2 biomarker, and serum chitinase-3-like protein 1 (YKL-40), a useful biomarker for COPD, in Japanese patients with asthma, ACO, or COPD, and investigate the role of these biomarkers in identifying ACO. METHODS: Subjects included Japanese patients with asthma (n = 177), ACO (n = 115), or COPD (n = 61). Serum periostin, YKL-40, and total IgE, blood eosinophils, and fractional exhaled nitric oxide were measured and compared among the patients. RESULTS: Serum periostin was high in both asthma and ACO, but not in COPD, whereas serum YKL-40 was high in both COPD and ACO, but not in asthma. Serum periostin levels correlated weakly with eosinophil counts in asthma, ACO, and COPD. Multivariate linear regression analysis revealed that older age, lower body mass index, higher eosinophil counts, higher total IgE, and the absence of the diagnosis of COPD were significantly associated with higher periostin levels. Based on cutoff values derived by receiver operating characteristic analysis (periostin: 55.1 ng/mL; YKL-40: 61.3 ng/mL), patients were classified into high or low groups. The proportion of patients with both high serum periostin and YKL-40 levels was significantly higher in ACO than in asthma or COPD. CONCLUSIONS: Serum periostin levels were comparable between asthma and ACO, whereas YKL-40 was comparable between ACO and COPD. Combined assessment of serum periostin and YKL-40 may identify ACO.
Authors: Sebastian Majewski; Damian Tworek; Karolina Szewczyk; Justyna Kiszałkiewicz; Zofia Kurmanowska; Ewa Brzeziańska-Lasota; Hanna Jerczyńska; Adam Antczak; Wojciech Jerzy Piotrowski; Paweł Górski Journal: Int J Chron Obstruct Pulmon Dis Date: 2019-07-22